Plasma Protein Biomarkers in Advanced or Metastatic Colorectal Cancer Patients Receiving Chemotherapy With Bevacizumab or Cetuximab: Results from CALGB 80405 (Alliance).

Abstract

PURPOSE:

CALGB 80405 compared the combination of first-line chemotherapy with cetuximab or bevacizumab in the treatment of advanced or metastatic colorectal cancer (mCRC). Although similar clinical outcomes were observed in the cetuximab-chemotherapy group and the bevacizumab-chemotherapy group, biomarkers could identify patients deriving more benefit from either biologic agent.

PATIENTS AND METHODS:

In this exploratory analysis, the Angiome, a panel of 24 soluble protein biomarkers were measured in baseline plasma samples in CALGB 80405. Prognostic biomarkers were determined using univariate Cox proportional hazards models. Predictive biomarkers were identified using multivariable Cox regression models including interaction between biomarker level and treatment.

RESULTS:

In the total population, high plasma levels of Ang-2, CD73, HGF, ICAM-1, IL6, OPN, TIMP-1, TSP-2, VCAM-1, and VEGF-R3 were identified as prognostic of worse progression-free survival (PFS) and overall survival (OS). PlGF was identified as predictive of lack of PFS benefit from bevacizumab [bevacizumab HR, 1.51; 95% confidence interval (CI), 1.10-2.06; cetuximab HR, 0.94; 95% CI, 0.71-1.25; Pinteraction = 0.0298] in the combined FOLFIRI/FOLFOX regimens. High levels of VEGF-D were predictive of lack of PFS benefit from bevacizumab in patients receiving FOLFOX regimen only (FOLFOX/bevacizumab HR, 1.70; 95% CI, 1.19-2.42; FOLFOX/cetuximab HR, 0.92; 95% CI, 0.68-1.24; Pinteraction = 0.0097).

CONCLUSIONS:

In this exploratory, hypothesis-generating analysis, the Angiome identified multiple prognostic biomarkers and two potential predictive biomarkers for patients with mCRC enrolled in CALGB 80405. PlGF and VEGF-D predicted lack of benefit from bevacizumab in a chemo-dependent manner. See related commentaries by Mishkin and Kohn, p. 2722 and George and Bertagnolli, p. 2725.

• Authors: Andrew B Nixon, Alexander B Sibley, Yingmiao Liu, Ace J Hatch, Chen Jiang, Flora Mulkey, Mark D Starr, John C Brady, Donna Niedzwiecki, Alan P Venook, Luis Baez-Diaz, Heinz-Josef Lenz, Bert H O'Neil, Federico Innocenti, Jeffrey A Meyerhardt, Eileen M O'Reilly, Kouros Owzar, Herbert I Hurwitz
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 28 Issue 13 Pg. 2779-2788 (07 01 2022) ISSN: 1557-3265 [Electronic] United States
• PMID: 34965954 (Publication Type: Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Journal Article)
• Copyright: ©2021 American Association for Cancer Research.

Chemical References

• Biomarkers
• Vascular Endothelial Growth Factor D
• Bevacizumab
• Cetuximab
• Leucovorin
• Fluorouracil

Topics

• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects)
• Bevacizumab (administration & dosage)
• Biomarkers
• Cetuximab (administration & dosage)
• Colonic Neoplasms (drug therapy)
• Colorectal Neoplasms (pathology)
• Fluorouracil (administration & dosage)
• Genotype
• Humans
• Leucovorin (administration & dosage)
• Phenotype
• Vascular Endothelial Growth Factor D (genetics, therapeutic use)